Ex-Addicts Find Methadone More Elusive Than Heroin

By CHRISTOPHER S. WREN

Published: February 2, 1997

CONCORD, N.H., Jan. 27—
Every morning before dawn, Omere Luneau climbs into his sport utility vehicle and drives south for two hours to a private clinic in Lawrence, Mass., where he swallows a cherry-red liquid and, upon demand, produces a urine sample. Then he drives for another two hours back to New Hampshire to start the day's work as a builder and restorer of old houses.

His stop in Lawrence can take barely five minutes, but Mr. Luneau, 48, makes the four-hour commute because he is one of 115,000 Americans who use methadone, a medication that kills the craving for opiates like heroin. New Hampshire does not allow methadone clinics, so Mr. Luneau must travel to another state for the medication that lets him turn his back on heroin.

''Methadone is the only thing I've found that is effective,'' Mr. Luneau said. ''It blocks the desire, the need to take drugs.'' He pays $375 a month from his own pocket for methadone, plus $250 for gas, oil and other car expenses. ''Sometimes it's a white-knuckle experience,'' churning through the snow and ice of a New England winter to arrive before the clinic closes at 9 A.M., he said.

Methadone, a synthetic narcotic painkiller, is widely accepted as a cure for heroin addiction, although normally it must be used for long periods. But as the country's most tightly controlled legal drug, it must be dispensed at licensed clinics, and almost never by doctor's prescription. Eight states -- Idaho, Mississippi, Montana, North Dakota, South Dakota, West Virginia, Vermont and New Hampshire -- have no such clinics, making the drug harder to find for people who need it than the heroin they are trying to resist.

One of the few recovering addicts to get methadone by prescription is Alice Randolph-Diorio of Vermont. She has had surgery 26 times because of degeneration of her pelvis and spine. ''It's frightening to think that the only way for a person to get methadone here is to suffer from chronic pain,'' Ms. Randolph-Diorio said.

Because Vermont has no such clinics, she used to drive to Westfield, Mass., a three-hour round trip, until a doctor convinced health officials that she needed methadone to block pain. ''What it's done for me is that it's allowed me to feel normal,'' said Ms. Randolph-Diorio, who became addicted to heroin as a teen-ager in Greenwich, Conn. ''I cannot get high. I've learned to deal with things that are very stressful without running to find euphoria.''

Though advocates of methadone say it does not induce a high in anyone who previously abused heroin, the Federal Government tightly regulates the medication. The Government's schedule of controlled substances lists methadone alongside cocaine as a drug with a high potential for abuse but with an accepted medical use.

''A methadone patient is monitored more closely than a paroled murderer,'' said Dr. Edwin A. Salsitz, who runs the methadone program at Beth Israel Hospital in New York City. ''Even someone who may be working has to be monitored because of regulations, and clinics themselves come up with regulations,'' Dr. Salsitz said.

Terrance W. Woodworth, deputy director of the Drug Enforcement Administration's Office of Diversion Control, said stringent controls on methadone were mandated by Congress in 1974. ''Methadone is a very potent Schedule II narcotic that can cause very serious damage to public health and safety,'' Mr. Woodworth said. ''It's not something that we want to take our effort away from. If we did not see methadone being diverted and causing so many deaths and arrests, we might redirect our efforts elsewhere.''

But a study released in 1995 by the Institute of Medicine, a branch of the National Academy of Sciences, found that methadone caused only ''minimal medical harm.'' It said, ''The number of cases in which methadone has been documented as the sole direct cause of death is very small.''

The Government refuses to let addicts routinely take methadone home, arguing that they might sell it to buy illegal drugs. Addicts themselves acknowledge that some methadone does get diverted, but only to other addicts who cannot get into treatment programs. The nation has an estimated 600,000 heroin users but only 115,000 treatment slots.

''If I wanted to get high, I'd buy heroin,'' said Joycelyn Woods, the executive vice president of the National Alliance of Methadone Advocates. ''It's cheaper and it's all over the street. But if I want to stabilize my life, I'm going to go for methadone, and addicts know this.''

David C. Lewis, the director of Brown University's Center for Alcohol and Addiction Studies, confirmed that methadone is not popular as a street drug. The real problem, Dr. Lewis said, is that ''patients have practically no status in this equation.''

''So far,'' he said, ''drug addicts are nearly at the bottom of the barrel when it comes to the consumers having a voice in their treatment.''

The ordeal was illustrated by a couple in Iowa who work together as long-distance truckers and must find clinics along their route to provide daily methadone for their former addiction. They have not told their company that they use methadone, which does not impair driving.